Brewer move OK for now

Citing high anticipated costs and other reservations, Gov. Jan Brewer declined the option to create an Arizona-based online health-care exchange under the new Affordable Care Act.

By doing so, Brewer is ceding control over Arizona's health-care marketplace to the federal government -- not a good idea, overall.

Still, the governor's reasons for declining to set up the exchange are defensible. Should it prove to be in Arizona's better interests in the years to come to establish its own exchange, the decision is not irrevocable.

Running a state-based exchange would not be cheap. Estimates ranged from $27 million to $40 million per year starting in 2015. The likelihood of Arizona's conservative Legislature approving that much money for a law most of the lawmakers despise was about the same as the chance they would approve an exchange in the first place: Not likely at all.

The Affordable Care Act is rife with unknowns. Rule-writers at the U.S. Department of Health and Human Services still are struggling with how to implement the 2,700-page law.

It may be to Arizona's advantage to take our time, learn from the mistakes of others, and implement the law on our own terms. That was the recipe for the Arizona Health Care Cost Containment System, the state's much admired version of Medicaid. It seems a prudent approach to implementing "Obamacare" as well.

Legal issues remain to be sorted out. The Goldwater Institute opposed setting up a state-run exchange based on its belief the law as written penalizes businesses for failing to offer employees insurance coverage only in those states with state-run exchanges. A lawsuit filed by Oklahoma is challenging that part of the health-care law.

Waiting also will let state leaders more objectively analyze another key element of the law: its universality. As a federal law, must the costs and benefits of an exchange be uniform for all citizen-participants, no matter where they live? If so, the advantage of local control would be small. If not, local control makes a great deal of sense.

We only now are beginning to see the enormous challenges that lay ahead in turning the huge Affordable Care Act into a reality.

The federal government is literally constructing a market, which by definition will include countless thousands of moving parts between its HHS nerve center in Washington, D.C., and the exchanges that ultimately sell the insurance to its citizen-customers.

This is going to be a challenge. We still believe that local control of the exchange will be in Arizona's best interests. But bringing it online in slow motion may not be the worst thing for Arizona health-care consumers.